Don’t be pelvic floored: How to avoid incontinence in your 60s

So, the temperature’s warmed up and we’re in a panic about losing that generous layer of insulation our bodies acquired over the winter. Before we hit the pavement, there are a few things we should know so we don’t damage a hidden, but important part of our anatomy; our pelvic floor. That’s the trampoline-shaped muscle and connective tissue group suspended between our tail bone and pubic bone that holds up our pelvic organs and helps close off our urinary and anal sphincters.

A startling number of people are affected by incontinence, often due to a weak pelvic floor. One in three women who’ve ever had a baby will leak urine, and this ratio increases to one in two once they reach 50. Men too, particularly after the age of 65, are at risk of incontinence as a result of enlarged prostates.

In total, there are about 4.8 million adult Australians affected by incontinence, making it more prevalent that asthma (2 million), arthritis (3.1 million) and anxiety disorders (2.3 million).

Incontinence can have serious impacts on our social lives, personal relationships and sexual function. However, it is entirely avoidable and treatable in the majority of cases.

One of the most important things we can do to avoid or improve incontinence is to protect our pelvic floor. While some activities strengthen the pelvic floor, others can do harm if the pelvic floor is in bad shape.

Activities that can harm the pelvic floor:

• Unsafe exercises

Any exercise that increases pressure in the abdominal cavity puts a downward force on the pelvic floor. High-impact exercises like jumping, skipping and running, and resistance exercises like lunges, jump squats and weights, while perfectly okay if the pelvic floor is strong, can stretch and damage the pelvic floor if it is out of condition. There are plenty of pelvic floor-safe exercises you can do in the meantime. Check some out at pelvicfloorfirst.org.au

• Constipation

Constipation can affect the pelvic floor in much the same way that resistance exercises do; straining on the toilet places extra downward pressure on the pelvic floor. On top of that, a full, impacted bowel can take up so much space in the pelvis, it can squeeze the bladder, risking leakage.

• Weight

Carrying excess body weight places constant, downward pressure on the pelvic floor. There is plenty of evidence showing that losing just five to 10 per cent of body weight reduces the likelihood of incontinence by about 70 per cent.

Apart from protecting our pelvic floor, there are a few other things we can do to help prevent incontinence:

• Drink well

Avoid drinking too much fluid or too little. The rule is simple; drink to satisfy your thirst. Too much will over-stretch your bladder and too little will concentrate your urine, which can irritate the bladder. A good guide as to how much to drink is the colour of your urine, which should be straw-coloured, and you should “go” between four and eight times a day.

• Get into good bladder and bowel habits

Go to the toilet when you feel the need to urinate. Don’t get into the habit of waiting till you’re busting or going “just in case”, unless it’s just before bedtime.

You should always respond to the urge to open your bowel. The ideal time to “go” is when you feel the gastro-colic reflux, a mass movement of contents along the bowel, which usually happens about 20 minutes after a meal, usually most strongly felt after breakfast. Avoid “holding on” because you risk constipation, as the stool continues to dry out and harden in the colon.

• Do your pelvic floor exercises

About half of us don’t follow written instructions properly, so either ask a continence physio or nurse, or watch one of several good videos on the subject. continence.org.au is a good place to start.

• Seek professional help

Incontinence is not normal and needs to be checked out if it persists. A good first port of call is the free National Continence Helpline (1800 33 00 66), which is staffed by continence nurses who can provide confidential advice or refer you to your nearest continence service.

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